The use of the single purse-string parachute suturing technique for pancreaticojejunostomy in laparscopic pancreaticoduodenectomy / 中华肝胆外科杂志

ABSTRACT

Objective:To study the single purse-string parachute suturing technique for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy, and to determine its feasibility and safety.Methods:The clinical data of 71 patients who underwent laparoscopic pancreaticoduodenectomy using the single purse-string parachute suturing technique for pancreaticojejunostomy from October 2018 to October 2021 at the Second Hospital of Hebei Medical University were retrospectively analyzed. There were 41 males and 30 females, with age (59.1±9.7) years old. The operative time, intraoperative blood loss, complication rate and other data were analyzed.Results:All 71 patients successfully underwent total laparoscopic pancreaticoduodenectomy, with 5 patients who underwent 2D laparoscopic surgery and 66 patients 3D laparoscopic surgery. There were additional vascular resection and reconstruction in 2 patients. The operative time was (388.9±92.9) min, the intraoperative blood loss was (411.3±176.9) ml, and the postoperative hospital stay was (14.1±5.8) d. The operation time of 71 patients who underwent the single purse-string parachute technique of pancreaticojejunostomy was (26.9±6.8) min. Postoperative complications occurred in 18 patients (25.4%). Grade B pancreatic fistula occurred in 2 patients (2.8%), and the longest time for removal of abdominal drain was 17 days after operation. Among the 71 patients, complications including biliary fistula occurred in 6 patients (8.5%), delayed gastric emptying in 5 patients (7.0%), pulmonary infection in 4 patients (5.6%), non-pancreatic fistula-related abdominal infection in 4 patients (5.6%), non-pancreatic fistula-related abdominal bleeding in 1 patient (1.4%), biliary tract bleeding in 1 patient (1.4%), and chylous leakage in 2 patients (2.8%).Conclusion:The single purse-string parachute technique of pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy had the advantages of being safe and reliable. The procedure is worthy of furthers promotion.